• Title/Summary/Keyword: 치료 순응도

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Effect of Onion Extracts on Serum Cholesterol in Borderline Hypercholesterolemic Participants (양파추출물 섭취가 경계역 고콜레스테롤혈증 대상자의 콜레스테롤 저하에 미치는 효과)

  • Lee, Hyun-Jin;Lee, Kyung-Hea;Park, Eun-Ju;Chung, Hye-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.12
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    • pp.1783-1789
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    • 2010
  • The aim of this study was to examine the effects of 10 week onion extract supplementation on blood lipid profiles in borderline hypercholesterolemic participants. The study consisted of 10 males and 17 females aged $45.9{\pm}10.0$ years. At baseline, serum total cholesterol level was $228.6{\pm}4.1$ mg/dL (201~239 mg/dL). This study was designed as randomized single blind placebo controlled cross-over study. After 1 week wash-out period, subjects were randomized into two groups; they took onion extract (150 mL/1 pack, containing 30 mg quercetin) or placebo for 10 weeks. After 1 week wash-out period again, subjects took exchanged samples for another 10 weeks. The total-cholesterol ($226.7{\pm}4.6{\rightarrow}206.8{\pm}3.6$ mg/dL; p<0.01), LDL-cholesterol ($151.6{\pm}5.0{\rightarrow}127.1{\pm}4.1$ mg/dL; p<0.01) and atherogenic index (AI: $4.0{\pm}0.3{\rightarrow}3.4{\pm}0.2$; p<0.05) decreased significantly after 10 weeks of onion extracts supplementation, while there were no significant changes during placebo periods. The levels of HDL-cholesterol (onion extract: $46.5{\pm}2.0{\rightarrow}50.2{\pm}2.1$ mg/dL, placebo: $47.8{\pm}2.1{\rightarrow}50.1{\pm}2.4$ mg/dL), GOT (onion extract: $36.8{\pm}1.8{\rightarrow}32.3{\pm}1.8$ IU/L, placebo: $35.1{\pm}2.1{\rightarrow}32.8{\pm}2.0$ IU/L), and GPT (onion extract: $36.5{\pm}3.2{\rightarrow}32.9{\pm}1.8$ IU/L, placebo: $36.6{\pm}3.8{\rightarrow}33.8{\pm}2.8$ IU/L) showed no significant changes in both periods. These results indicate that the consumption of onion concentrated extracts exerts beneficial effects on dyslipidemia through the decrease of serum total cholesterol and LDL cholesterol levels in borderline hypercholestrolemic subjects. In conclusion, onion was useful as dietary therapy for hypercholestrolemia and adequate onion intake may help to prevent cardiovascular disease.

Experience of Treatment Adherence in Korean Patients with HIV (한국 HIV 감염인의 치료 순응경험)

  • Park, Yunhee;Seo, Min Jeong;Kim, Sanghee;Park, Soon-Young
    • Journal of Korean Academy of Nursing
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    • v.44 no.4
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    • pp.407-417
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    • 2014
  • Purpose: The purpose of this study was to explore the subjective experience of Highly active Antiretroviral therapy (HAART) adherence in Korean patients with HIV. Methods: A phenomenological methodology was used for the study. Data were collected from March to December, 2013 using open-ended questions during in-depth interviews. Participants were taking HAART for HIV, and were contacted through purposive techniques. Results: Four men and 4 women whose average treatment period was 5.9 years participated in this study. Seven themes emerged from the analysis using Colazzi's method: (a) Seizing life in a deep sense of despair, (b) Struggling with medication, (c) Facing harsh treatment from health care providers, (d) Spoiling healthy pattern, (e) Hungering for communication and emotional support, (f) Turning to accepting HIV, (g) Becoming adherent to HIV treatment. Conclusion: Prejudice from health care providers and lack of emotional support were barriers to HAART in Korea. Intervention strategies are needed to decrease prejudices from health care providers and to increase family support.

The Psychosocial Aspects of the Patients with Chronic Hepatitis B (만성 B형 간질환 환자의 정신사회적 측면)

  • Kim, Jin-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.3-10
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    • 2000
  • Objectives : The author wanted to summarize the psychiatric and social aspects of the patients with hepatitis B virus infection. Methods : The author reviewed all pertinent citations in the Medline database from 1966 to 1999. Results : Psychiatric problems in this population include delirium, psychotic disorder due to general medical condition(especially mania), anxiety, depression, adjustment disorder, alcohol abuse/dependence, and drug abuse/dependence. Social aspects of the patients with hepatitis B viral infection relate to the stigma of being a carrier, guilty feeling about infection, guilty feeling about increased family burden, impacts of having hepatitis on interpersonal relations, sexual difficulties, and job loss with increased financial burden, and health care worker's refusal. Conclusions : Appropriate early educational counseling interventions regarding the expected course and psychosocial intervention should be tailored to the sociocultural needs of special populations. Those interventions will increase compliance of treatment and prevent progression to hepatocellalar carcinoma from hepatitis.

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Eradication Effect of Penicillin Administration on the Asymptomatic Infections of Group A Streptococci (A군 연쇄구균 무증상 감염자에서 페니실린 투여 후 세균제거 효과에 대한 조사)

  • Jung, Hyun-Ju;Kim, Seon-Ju
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.215-220
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    • 1998
  • Purpose : Asymptomatic infections with positive throat culture for group A beta-hemolytic streptococci(GABHS) and high antistreptolysin O(ASO) concentration may lead to sequelae such as rheumatic fever or acute poststreptococcal glomerulonephritis. Children with asymptomatic infections were treated with oral penicillin V to evaluate the effectiveness of penicillin treatment on the asymptomatic infections. Methods : Throat culture and ASO concentration analysis were performed against healthy elementary school children. Thirty-six children with positive throat culture for GABHS and ASO concentrations of 400 IU/mL or more were divided into two groups. Twenty-two children were treated with oral penicillin V for 10 days, and the others were not treated. Eradication rate of GABHS and the change of ASO concentration between the two groups were compared after one month later. Results : Eradication rates of GABHS between treated and untreated children were 91%(20/22) and 50%(7/14) respectively(P<0.05). Children showing elevation of ASO levels more than 100IU/mL were 22%(4/18) in the treated group and 30%(3/10) in the untreated group, while children showing a decrease of more than 200IU/mL in the ASO level were 44%(8/18) and 40%(4/10) respectively. Conclusion : We confirmed the validity of penicillin treatment, because when we treated the asymptomatic children with penicillin V, the GABHS was eradicated effectively. But there was no significant difference of decrease in the ASO levels between the two groups due to long half-life of ASO or poor compliance. Treatment failure was 22% in terms of elevated ASO levels after penicillin treatment.

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Joint Symptoms During Antituberculous Chemotherapy (결핵 치료 중 나타나는 관절 증상)

  • Kim, Sang-Cheol;Baik, Jae-Joong;Lee, Tae-Hoon;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.162-168
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    • 2000
  • Background : Joint symptoms frequently occur in the course of antituberculous chemotherapy and tend to be ignored and overlooked, but in some cases, they are often very troublesome in obstructing ordinary life. Joint symptoms that develop during antituberculous chemotherapy need to be understood, but there are few materials describing them systematically. Method : This study enrolled 33 patients with tuberculosis treated with first line antituberculous agents for more than 6months. In the course of treatment, joint symptoms not associated with specific cause, such as preexisting joint disease or trauma, were investigated and compared with thæe of the asymptomatic group. We confirmed the incidence of joint symptoms and factors associated with them. Results : Nineteen of 33 patients (58%) had joint symptoms. Joint symptoms developed 1.9$\pm$1.4 months after the beginning of chemotherapy and lasted for 3.6$\pm$2.5months. In 18 of 19 symptomatic patients, multiple joints were involved: shoulder (10 patients, 53%), knee (10, 53%), finger (6, 32 %). Joint symptoms were expressed as pain (19 patiens, 100%), stiffness (7, 37%) and/or swelling (3, 16%). Fourteen patients (74%) took analgesics to relieve their symptoms and in 2 patients, antituberculous agents were discontinued because of the severity of their symptoms. The symptoms seem to be caused by agents other than pyrazinamide, but it was very difficult to identify the definite causative agent. In age, sex, underlying disease and serum uric acid level, no significant differences were noted between the two groups. Conclusions : Although joint symptoms are common during antituberculous chemotherapy, their development is difficult to predict. Because some joint symptoms can become very bothersome, the physician should pay close attention to these symptoms.

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Combined Chemotherapy and Radiotherapy versus Radiotherapy alone in the Management of Localized Angiocentric Lymphoma of the Head and Neck (국한성 두경부 혈관 중심위 림프종에서 화학방사선 병용치료법과 방사선치료 단독요법의 비교)

  • Chang Sei Kyung;Kim Gwi Eon;Lee Sang-Wook;Park Hee Chul;Pyo Hong Ryull;Kim Joo Hang;Moon Sun Rock;Lee Hyeong Sik;Choi Eun Chang;Kim Kwang Moon
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.17-23
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    • 2002
  • Purpose : To clarify the clinical benefit derived from the combined modality therapy (CMT) consisting of chemotherapy (CT) and involved field radiotherapy (RT) for stage I and II angiocentric lymphomas of the head and neck. Materials and Methods : Of 143 patients with angiocentric lymphoma of the head and neck treated at our hospital between 1976 and 1995, 104 patients (RT group) received involved field RT alone with a median dose of 50.4 Gy (range : 20~70 Gy), while 39 patients (CMT group) received a median 3 cycles (range : 1~6 cycles) of CT before involved field RT. The response rate, patterns of failure, complications, and survival data of the RT group were compared with those of the CMT group. Results : Despite a higher response rate, local failure was the most common pattern of failure in patients of both groups. The patterns of failure, including the systemic relapse rate were not influenced by the addition of combination CT. Although both modalities were well tolerated by the majority of patients, aberrant immunologic disorders or medical illnesses, such as a hemophagocytic syndrome, sepsis, intractable hemorrhage, or the evolution of second primary malignancies were more frequently observed in patients of the CMT group. The prognosis of patients in the RT group was relatively poor, with a 5-year overall actuarial survival rate of 38% and disease-free survival rate of 32%, respectively. However, their clinical outcome was not altered by the addition of systemic CT. Achieving complete remission was the most important prognostic factor by univariate and multivariate analyses, but treatment modality was not found to be a prognostic variable influencing survival. Conclusions : Involved field RT alone for angiocentric lymphoma of the head and neck was insufficient to achieve an improved survival rate, but the addition of CT to involved field RT failed to demonstrate any therapeutic advantage over involved field RT alone.

Isolated Leukopenia During Antituberculosis Treatment (1차 항결핵약제 치료 중 발생한 백혈구감소증의 추이)

  • Song, Heon-Ho;Lim, Chae-Man;Lee, Sang-Do;Go, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.420-427
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    • 2000
  • Background : Isolated leukopenia is rare, but it has important clinical implications during antituberculosis treatment. Inadvertent discontinuation of short-course regimen drugs for fear of leukopenia inevitably will extend the duration of treatment, and the completion of treatment will be delayed. However no guidelines concerning proper management for leukopenia during antituberculosis treatment have been presented. Therefore, this study was performed to evaluate the possibility of continuing the same short-course regimen if a mild-to-moderate degree of isolated leukopenia was to develop during antituberculosis treatment. Method : Thirty-six patients who had been prescribed a short-course antituberculosis regimen between January 1997 and August 1999, had newly developed, mild-to-moderate degree, isolated leukopenia during medication, and had continued the same drug regimen despite leukopenia were enrolled. One patient was not available for the follow-up, so the remaining thirty-five (twenty-five prospectively and ten retrospectively) patients were analyzed. Patients who had other known causes of leukopenia were excluded. A mild-to-moderate degree of isolated leukopenia was arbitrarily defined as having a peripheral blood leukocyte count between 2,000 and $3,499/mm^3$ and no evidence of coexisting hematologic abnormalities. Results : 1) All thirty-five patients were able to complete short-course anti-tuberculosis treatment without complication or further decrease of leukocytes count to less than $2,000/mm^3$ despite continuous treatment with the same regimen. 2) The mean duration from start of antitituberculosis medication to detection of leukopenia was $64{\pm}65$ days. 3) The mean leukocyte count was $5,035{\pm}1,583/mm^3$ before treatment, and the its lowest count was $2,908{\pm}390/mm^3$ during treatment. Leukopenia recovered after completion of treatment ($4,283{\pm}1,269/mm^3$). 4) The main component of leukopenia was the decrease in neutrophil count ($3,361{\pm}1,732$ vs. $1,512{\pm}423/mm^3$, p<0.05). Conclusion : For mild-to-moderate degree of isolated leukopenia ($2,000/mm^3{\leq}$ WBC < $3,500/mm^3$), developing during short-course antituberculosis treatment, the short-course antituberculosis regimen may be continued without complications.

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Perineal Skin Toxicity according to Irradiation Technique in Radiotherapy of Anal Cancer (항문암의 방사선치료 시 방사선 조사 기법에 따른 회음부 피부 독성)

  • You, Sei-Hwan;Seong, Jin-Sil;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.222-228
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    • 2008
  • Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.

Concurrent Cisplatin-Radiation Therapy in Locally Advanced Head & Neck Cancers - Preliminary Report - (국소진행된 두경부종양의 Cisplatin-방사선 동시병용치료 - 예비적 임상결과보고 -)

  • Kim In Ah;Choi Ihl Bhong;Cho Seung Ho;Hong Young Seon;Choi Byung Ok;Kang Young Nam
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.205-210
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    • 2001
  • Purpose : This study tried to evaluate the effectiveness of combined treatment using radiation therapy and concurrent cisplatin as a radiosensitizer in the management of locally advanced head and neck cancer. Materials and methods : From January 1995 to August 1998, 29 evaluable patients with locally advanced head & neck cancels (AJCC stage $II\~IV$) were received curative radiation therapy $(total\;70\~75.6\;Gy/35\~42\;fractions,\;1.8\~2\;Gy/fraction)$ and concurrent cisplatin chemotherapy ($100\;mg/m^2$, D1, D22, D43). The neck dissections were peformed for residual lymphadenopathy. Follow-up ranged from 5 to 55 months (median 24 months). Results : Twenty-one $(72.4\%)$ patients achieved clinical complete responses. The partial response and minimal response rates were $17.2\%\;and\;10.4\%$, respectively. Locoregional failure rate was $27.6\%$, and included 6 patients with local failures, 4 patients with regional failures, and 2 patients with combined local and regional failures. Four of 29 patients $(13.8\%)$ developed distant metastasis. The disease free survival rate at 3 years was $60\%$. Nasopharyngeal primary tumors or complete responders showed significantly higher disease free survival rate. The grade 3 mucositis and nausea/vomiting was noted in $34.5\%$, respectively. Major prolongation of radiation therapy duration was inevitable in three patients. Twenty-one patients $(72.4\%)$ completed 3 courses of cisplatin and 5 patients received 2 courses of cisplatin. Three patients received only one course of cisplatin due to nephrotoxicity and neurotoxicity, and then changed to 5-FU regimen. Conclusions : Concurrent cisplatin-radiation therapy in locally advanced head and neck cancer showed high response rate, reasonable locoregional control, and survival rate. As expected, acute toxicities were increased, but compliance to treatment was acceptable. Assessment of the effect of the combination in this setting requires further accrual and follow-up.

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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